Staying connected

Social support comes in a variety of forms. It can be helpful to enquire about an individual’s access to all of these kinds of social support.

• Emotional support: includes connection with individuals or groups, characterised by the offering of empathy, concern, affection, love, acceptance, encouragement, or caring. It involves talking about feelings with people who show care and concern, and can be non-judgmental. It also often involves discussion of the disaster and the stressors associated with recovery in a supportive fashion, and can come from trusted family or friends, or be in the context of professional mental health service provision.
• Instrumental or practical support: connections with individuals or groups that can provide practical assistance, finance, material goods, or services. Examples might include help with things such as babysitting, making food, or driving to appointments, to name a few.
• Informational support: support that comes in the form of necessary advice, guidance, suggestions, or useful information that can assist in problem-solving. This kind of support should ideally be provided by individuals or organisations of whom the disaster-impacted individual can ask questions and trust that they will provide accurate information. This may be particularly relevant in the post-disaster period where there has been loss of life and limb, housing, jobs, local infrastructure, etc.
• Companionable support: the type of support that gives someone a sense of belonging, often via social activities, is pleasant and comfortable but does not necessarily involve sharing of emotions, discussion of the disaster, or emotional functioning. Examples might include participating in crafting and hobby groups, ‘men’s shed’ activities, or watching television for relaxation.

Enquire about children’s access to people they can talk to about their disaster experience and how they are feeling.

1. Provide psychoeducation about social support

Encourage disaster-impacted individuals to understand that social support is important for mental health generally and for recovery from disaster more specifically. After disaster, people may be dislocated from their usual environments and may have moved. Normal social support networks may be entirely disrupted or less easily available. In the aftermath of disaster, it can be helpful to review the types of support needed and to consider how to gain access to them. It is also important to acknowledge that disaster may result in additional burdens and stresses for individuals and communities, making it difficult for some to ask for help because they feel too busy or overwhelmed, or conversely they do not wish to burden others. Further, if survivors have had a loved one die in the disaster, grief may be prominent and may make it more difficult for the individual to engage with available social supports and connections. Do not push survivors to engage in social connections before they feel ready to do so.

2. Map social support by completing a social support planning exercise

Provide a Social support planning worksheet and work with the disaster-impacted individual to complete the document. Some survivors will have difficulty staying in the present while doing social mapping and some may find themselves focussing more on losses (deaths of loved ones, friends who have moved away, or people with whom they’ve lost contact). Acknowledge these and gently help them to refocus on people and activities in the here and now. If they seem unable to do this, additional mental health support may be beneficial.

3. Encourage social support for children

Children maintain social connections and deal with intense physiological and emotional reactions through their play. However, after a disaster, children may disengage from play and mimic the energy and posture of their caregivers. For children, playing with others is important for their recovery. Parents and caregivers should gently find opportunities for, and encourage their children to play in small groups. Caregivers can help guide children’s play to be constructive, fun, and not focussed on replaying the disaster.

It is important to monitor the success or otherwise of plans to increase social support. As social support relies on the availability and personality of others, access to the necessary supports may be slow to occur. Ongoing follow-up may serve to highlight the issue and keep it ‘on the agenda’. It may also allow the health practitioner to encourage seeking other avenues for support where initial attempts are unsuccessful.

Recommended reading list:

• Berkowitz, S., Bryant, R., Brymer, M., Hamblen, J., Jacobs, A., Layne, C., Macy, R., Osofsky, H., Pynoos, R., Ruzek, J., Steinberg, A., Vernberg, E., & Watson, P. (2010). Skills for Psychological Recovery: Field Operations Guide. US: The National Center for PTSD & the National Child Traumatic Stress Network. Available at: www.ptsd.va.gov/professional/treat/type/SPR/SPR_Manual.pdf
• Lon Thoresen, S., Birkeland, M. S., Arnberg, F. K., Wentzel-Larsen, T., & Blix, I. (2019). Long-term mental health and social support in victims of disaster: comparison with a general population sample. BJPsych open, 5(1). doi.org/10.1192/bjo.2018.74
• Osofsky, J. D., & Osofsky, H. J. (2018). Challenges in building child and family resilience after disasters. Journal of Family Social Work, 21(2), 115–128. doi.org/10.1080/10522158.2018.1427644
• Shakespeare-Finch, J., Obst, P., & Rogers, E. (2019). The Influence of Giving and Receiving Social Support on the Psychological Outcomes of Two Trauma-Exposed Samples. Journal of Loss & Trauma, 24(8), 766–781. doi.org/10.1080/15325024.2019.1652407